Surgical clip applier

ABSTRACT

A surgical clip applier is provided including a housing; at least one handle pivotably connected to the housing; a channel assembly extending distally from the housing; a plurality of clips loaded in the clip carrier; a drive channel translatably supported in the housing and the channel assembly, the drive channel being translated upon actuation of the at least one handle; and a counter mechanism supported in the housing, the counter mechanism including indicia visible through the housing, wherein the indicia corresponds to a quantity of clips loaded in the clip applier, wherein the indicia decrements upon each firing of the clip applier resulting in a reduction in the quantity of clips remaining of the plurality of clips.

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.12/939,296 filed Nov. 4, 2010, which claims the benefit of and priorityto U.S. Provisional Application Ser. No. 61/285,006, filed on Dec. 9,2009, the entire content of which is incorporate herein by reference.

BACKGROUND

1. Technical Field

The present application relates to surgical instruments, and moreparticularly, to surgical clip appliers having a plurality of clips forapplying the clips to body tissues and vessels during surgicalprocedures.

2. Discussion of Related Art

Surgical clip appliers are known in the art and have increased inpopularity among surgeons by offering an alternative to conventionalsuturing of body tissues and vessels. Typical instruments are disclosedin U.S. Pat. No. 5,030,226 to Green et al. and U.S. Pat. No. 5,431,668to Burbank, III et al. These instruments generally provide a pluralityof clips which are stored in the instrument and which are fedsequentially to the jaw mechanism at the distal end of the instrumentupon opening and closing of the handles at the proximal end of theinstrument. As the handles are closed, the jaws close to deform a clippositioned between the jaw members, and as the jaws are opened torelease the deformed clip, a new clip is fed from the series to aposition between the jaws. This process is repeated until all the clipsin the series of clips have been used.

A need exists for a user of the clip applier to know how many clipsremain in the clip applier and/or to know when a final clip of theplurality of clips has been fired.

SUMMARY

The present application relates to surgical clip appliers having aplurality of clips for applying the clips to body tissues and vesselsduring surgical procedures and their methods of use.

According to an aspect of the present disclosure, a surgical clipapplier is provided including a housing; at least one handle pivotablyconnected to the housing; a channel assembly extending distally from thehousing; a plurality of clips loaded in the clip carrier; a drivechannel translatably supported in the housing and the channel assembly,the drive channel being translated upon actuation of the at least onehandle; and a counter mechanism supported in the housing, the countermechanism including indicia visible through the housing, wherein theindicia corresponds to a quantity of clips loaded in the clip applier,wherein the indicia decrements upon each firing of the clip applierresulting in a reduction in the quantity of clips remaining of theplurality of clips.

The counter mechanism may be rotatably supported in the housing and mayinclude a uni-directional clutch member permitting rotation of thecounter mechanism in a single direction. The counter mechanism mayinclude a counter dial rotatably supported in the housing, wherein thecounter dial includes the indicia thereof; and a counter clutchoperatively connected to the counter dial such that rotation of thecounter clutch in a first direction results in rotation of the counterdial in the first direction, and rotation of the counter clutch insecond direction results in no rotation of the counter dial.

The counter mechanism may include a latch member operatively engagedwith the counter dial. In use, the latch member permits rotation of thecounter dial in the first direction and inhibits rotation of the countermechanism in a direction opposite to the first direction.

The counter dial may include a plurality of grooves formed in an outerperiphery thereof, and the latch member may include a resilient fingerbiased into engagement with the plurality of grooves of the counterdial.

The counter clutch may be concentrically, rotatably nested in a boredefined in the counter dial. The counter clutch may include at least oneresilient finger extending therefrom for engagement with uni-directionalteeth formed in a perimetrical surface of the bore of the counter dial.

The drive channel may define an angled slot therein, and the counterclutch may include a clutch pin extending from a surface thereof and maybe slidably disposed in the angled slot of the drive channel. In use,translation of the drive channel in a first direction relative to thecounter mechanism would cause the clutch pin to be cammed by the angledslot thereof thereby causing the counter clutch to rotate in the firstdirection, and translation of the drive channel in a second directionrelative to the counter mechanism would cause the clutch pin to becammed by the angled slot thereof thereby causing the counter clutch torotate in the second direction.

The counter mechanism may include a latch member operatively engagedwith the counter dial. In use, the latch member permits rotation of thecounter dial in the first direction and inhibits rotation of the countermechanism in a direction opposite to the first direction.

The counter mechanism may include a counter dial defining a lock outgroove formed in an outer perimetrical edge thereof; and a lock outsupported in the housing. The lock out may be biased such that a firstcatch thereof engages against the outer perimetrical edge of the counterdial. In use, as the counter dial is rotated and the lock out groove ofthe counter dial is brought into registration with the first catch ofthe lock out, the first catch of the lock out is urged into the lock outgroove thereby preventing a rotation of the counter dial in an oppositedirection.

The lock out may include a second catch. In use, the second catch of thelock out moves into a path of a translating member of the clip applierwhen the first catch of the lock out is moved into the lock out grooveof the counter dial, thereby inhibiting a translation of the translatingmember of the clip applier.

The lock out groove of the counter dial may move into registration withthe first catch of the lock out when a final clip of the plurality ofclips has been fired. The lock out groove of the counter dial may beassociated with an indicia on the counter mechanism indicating that thefinal clip has been fired. The indicia on the counter mechanism,indicating that the final clip of the plurality of clip has been fired,may be represented by the number “zero.”

The clip applier may further include a ratchet mechanism having aratchet pawl pivotably supported in the housing; and a rack memberprovided on the translating member. The rack member may be in operativeregistration with the ratchet pawl. In use, the rack member translatesacross the ratchet pawl as the translating member translates. Theratchet mechanism may be prevented from re-setting when the rack memberhas not completed a fully translation.

BRIEF DESCRIPTION OF THE DRAWINGS

The present clip applier will be more fully appreciated as the samebecomes better understood from the following detailed description whenconsidered in connection with the following drawings, in which:

FIG. 1 is a perspective view of a surgical clip applier according to anembodiment of the present disclosure;

FIG. 2 is a top, plan view of the surgical clip applier of FIG. 1;

FIG. 3 is an enlarged view of the indicated area of detail of FIG. 2;

FIG. 4 is a perspective view of a mechanical counter assembly of thesurgical clip applier of FIGS. 1 and 2;

FIG. 5 is an exploded perspective view of the surgical clip applier ofFIGS. 1-4;

FIG. 6 is a perspective view of a handle assembly with a housinghalf-section removed therefrom and illustrating a counter of themechanical counter assembly engaged with a drive channel;

FIG. 7 is a perspective view of a handle assembly with a housinghalf-section and drive channel removed therefrom and illustrating thecounter of the mechanical counter assembly engaged with a ratchet;

FIG. 8 is an enlarged view of the indicated area of detail of FIG. 7;

FIG. 9 is a perspective view of a handle assembly with a housinghalf-section, the drive channel, and the ratchet removed therefrom;

FIG. 10 is a front, perspective view, with parts separated, of a counterand a clutch of the mechanical counter assembly;

FIG. 11 is a rear, perspective view, with parts separated, of thecounter and the clutch of the mechanical counter assembly of FIG. 10;

FIG. 12 is a rear, perspective view of the counter and the clutch of themechanical counter assembly of FIGS. 10 and 11;

FIG. 13 is a perspective view of a lock-out of the clip applier of FIGS.1-4;

FIG. 14 is a top plan, schematic illustration of the mechanical counterassembly operatively connected to the drive channel when the clipapplier is in an original unactuated position;

FIG. 14A is a side view of the mechanical counter assembly as viewedalong 14A-14A of FIG. 14;

FIG. 14B is an enlarged view of the indicated area of detail of FIG. 14;

FIG. 14C is a cross-sectional view of the mechanical counter assembly astaken along 14C-14C of FIG. 14A;

FIG. 15 is a top plan, schematic illustration of the mechanical counterassembly operatively connected to the drive channel when the clipapplier is initially actuated;

FIG. 15A is an enlarged view of the indicated area of detail of FIG. 15;

FIG. 15B is a cross-sectional view of the mechanical counter assembly astaken along 14C-14C of FIG. 14A, during the initial actuation of theclip applier;

FIG. 16 is a top plan, schematic illustration of the mechanical counterassembly operatively connected to the drive channel when the clipapplier is fully actuated;

FIG. 16A is an enlarged view of the indicated area of detail of FIG. 16;

FIG. 16B is a cross-sectional view of the mechanical counter assembly astaken along 14C-14C of FIG. 14A, following the full actuation of theclip applier;

FIG. 17 is a top plan, schematic illustration of the mechanical counterassembly operatively connected to the drive channel when the clipapplier is released after full actuation;

FIG. 17A is an enlarged view of the indicated area of detail of FIG. 17;

FIG. 17B is a cross-sectional view of the mechanical counter assembly astaken along 14C-14C of FIG. 14A, during a release of the clip applierfollowing full actuation;

FIG. 18 is a cross-sectional view of the mechanical counter assembly astaken along 14C-14C of FIG. 14A, illustrating the mechanical counterassembly fully re-set;

FIG. 19 is a top, plan view of the mechanical counter assembly,illustrating the counter at a “zero” position and locked out;

FIG. 19A is a cross-sectional view of the mechanical counter assembly astaken along 14C-14C of FIG. 14A, illustrating the counter at a “zero”position and locked out; and

FIG. 19B is an enlarged view of the indicated area of detail of FIG.19A.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of surgical clip appliers in accordance with the presentdisclosure will now be described in detail with reference to the drawingfigures wherein like reference numerals identify similar or identicalstructural elements. As shown in the drawings and described throughoutthe following description, as is traditional when referring to relativepositioning on a surgical instrument, the term “proximal” refers to theend of the apparatus which is closer to the user and the term “distal”refers to the end of the apparatus which is further away from the user.

Referring now to FIGS. 1-5, a surgical clip applier in accordance withan embodiment of the present disclosure is generally designated as 100.Surgical clip applier 100 generally includes a handle assembly 102including a housing 104 having an upper housing half 104 a and lowerhousing half 104 b. Handle assembly 102 further includes a pair ofhandles 106 pivotably secured to housing 104 and extending outwardlytherefrom. A channel assembly 108 is fixedly secured to housing 104 andextends outwardly therefrom, terminating in a jaw assembly 110.

As seen in FIGS. 1-5, housing halves 104 a and 104 b of clip applier 100fit together by snap fit engagement with one another. Housing 104defines a window 104 c formed in lower housing half 104 b for supportingand displaying a counter mechanism, as will be discussed in greaterdetail below.

As seen in FIG. 4, handles 106 are secured to housing 104 by handlepivot posts 104 d extending from lower housing half 104 b and intorespective apertures 106 a formed in handles 106. Handle assembly 102includes a link member 122 pivotally connected to each handle 106 at apivot point 106 b formed in a respective handle 106. A distal end ofeach link member 122 is pivotally connected to a pivot point formed in adrive channel 140 via a drive pin 124. Each end of drive pin 124 isslidably received in an elongate channel formed in a respective upperand lower housing half 104 a, 104 b. In use, as will be described ingreater detail below, as handles 106 are squeezed, link members 122 pushdrive channel 140 distally via drive pin 124.

Channel assembly 108 includes a channel or cartridge cover 130 and anouter or lower channel 132 each having a proximal end retained inhousing assembly 102, between upper and lower housing halves 104 a, 104b.

As seen in FIG. 5, clip applier 100 includes a clip pusher bar 160slidably disposed beneath cartridge cover 130, a stabilizer 162configured to overlie and engage pusher bar 160, a motion multipliersystem 155 supported in housing 104, a clip carrier 170 disposed withinchannel assembly 108 and beneath pusher bar 160, a stack of surgicalclips “C” loaded and/or retained within clip carrier 170 in a manner soas to slide therewithin and/or therealong, a clip follower 174 slidablydisposed within clip carrier 170 and positioned behind the stack ofsurgical clips “C,” a wedge plate 180 slidably disposed within handleassembly 102 and channel assembly 108, a wedge plate pivot arm 179pivotally supported in lower housing half 104 b of housing 104 fortransmitting translation of drive channel 140 to translation of wedgeplate 180, a drive channel 140 reciprocally supported in and extendingbetween housing 104 of handle assembly 102 and channel assembly 108, anaudible/tactile indicator 148 connected to drive channel 140 via drivepin 124, and a jaw assembly 110 mounted on or at a distal end of channelassembly 108 and actuatable by handles 106 of handle assembly 102.

Reference may be made to U.S. Provisional Application No. 61/091,467,filed on Aug. 25, 2008, entitled “Surgical Clip Applier” and U.S.Provisional Application No. 61/091,485, filed on Aug. 25, 2008, entitled“Surgical Clip Applier and Method of Assembly,” the entire contents ofeach of which being incorporated herein by reference, for a detaileddiscussion of the structure, operation, and method of assembly ofvarious components surgical clip applier 100. Reference may also be madeto U.S. Provisional Application No. 61/286,569, filed on Dec. 15, 2009,entitled “Surgical Clip Applier”, the entire contents of which isincorporated herein by reference, for additional detailed discussion ofthe structure, operation, and method of assembly of various componentsof surgical clip applier 100.

As seen in FIGS. 1-12, clip applier 100 further includes a mechanicalcounter mechanism 190 supported in housing 104 of handle assembly 102.Counter mechanism 190 includes a counter dial 192 rotatably disposedwithin housing 104 so as to overlie window 104 c formed in lower housinghalf 104 b, a counter clutch 194 operatively connected to counter dial192 and configured to permit uni-directional rotation of counter dial192, and a latch member 196 configured to engage counter dial 192.

As seen in FIGS. 4-11, counter dial 192 includes a first face 192 adisposed adjacent window 104 c formed in lower housing half 104 b. Firstface 192 a includes a plurality of indicia 192 b, in the form ofsequential numbers disposed thereof and substantially around a radialperiphery thereof. Indicia 192 b may correspond to the number of clipsthat are loaded in clip applier 100. By way of example only, indicia 192b may be numerals from “0-22.” Indicia 192 b are located on first face192 a so as to be in registration with window 104 c formed in lowerhousing half 104 b. Counter dial 192 includes a second face 192 c,opposite first face 192 b, and defining a bore 192 d therein. Bore 192 dincludes a radial array of uni-directional teeth 192 e formed therein.Counter dial 192 further includes a first or outer rim defining aplurality of grooves 192 f formed around an outer periphery thereof, anda second or inner rim defining a single groove 192 g formed in an outerperiphery thereof.

With continued reference to FIGS. 4-11, counter clutch 194 isconcentrically and rotatably nested in bore 192 d of counter dial 192.Counter clutch 194 of mechanical counter mechanism 190 includes a bodyportion 194 a configured and dimensioned for rotatable disposition inbore 192 d of counter dial 192. Counter clutch 194 includes a pair ofopposed resilient fingers 194 b, 194 c extending substantiallytangentially from body portion 194 a. Resilient fingers 194 b, 194 cextend from body portion 194 a by an amount sufficient so as toresiliently engage uni-directional teeth 192 e of dial 192. Counterclutch 194 includes a clutch pin 194 d extending from body portion 194 aand projecting out of bore 192 d of counter dial 192.

As seen in FIGS. 4-9, latch member 196 of mechanical counter mechanism190 is secured to lower housing half 104 b. Latch member 196 includes aresilient finger 196 a configured to contact and selectively engagegrooves 192 f formed around the outer periphery of counter dial 192.

As seen in FIGS. 5 and 6, drive channel 140 defines an angled slot 140 aformed therein at a location so as to slidably receive clutch pin 194 dextending from body portion 194 a of counter clutch 194. Angled slot 140a of drive channel 140 extends in a direction away from a longitudinalaxis of clip applier 100 from a proximal to a distal direction.

As seen in FIGS. 4, 5, 7 and 8, clip applier 100 includes a ratchet rackmember 141 slidably disposed in lower housing half 104 b. Rack member141 is pinned to drive pin 124 such that translation of drive pin 124relative to housing 104 results in concomitant translation of rackmember 141. Rack member 141 is disposed in housing 104 such that clutchpin 194 d of counter clutch 194 rides along or contacts a side edge 141b thereof. Rack member 141 includes ratchet teeth 141 a formed along anedge thereof and are configured and adapted to engage with a ratchetpawl 142 supported in housing 104. Rack member 141 and pawl 142 define aratchet mechanism 144.

In use, as drive channel 140 is moved axially by drive pin 124, rackmember 141 is also moved. Rack teeth 141 a of rack member 141 has alength which allows pawl 142 to reverse and advance back over rackmember 141 when rack member 141 changes between proximal and distalmovement as drive channel 140 reaches a proximal-most or distal-mostposition.

Pawl 142 is pivotally connected to lower housing half 104 b by a pawlpin at a location wherein pawl 142 is in substantial operativeengagement with rack member 141. Pawl 142 is engageable with rack member141 to restrict longitudinal movement of rack member 141 and, in turn,drive channel 140. Ratchet mechanism 144 further includes a pawl spring145 configured and positioned to bias pawl 142 into operativeassociation with rack member 141. Pawl spring 145 functions to maintainthe teeth of pawl 142 in engagement with the teeth 141 a of rack member141, as well as to maintain pawl 142 in a rotated or canted position.

As seen in FIGS. 4, 5, 7-9 and 13, clip applier 100 further includes alock out 146 pivotally connected or supported in housing 104. Lock out146 includes a body portion 146 a, a first catch 146 b formed at one andof body portion 146 a, and a second catch 146 c extending from a sideedge of body portion 146 a. First catch 146 b is configured anddimensioned to engage groove 192 g formed in the outer periphery of theinner rim of counter dial 192. Second catch 146 c is configured anddimensioned to engage a notch 141 c formed in a side edge of rack member141. A biasing member 147 is provided to maintain first catch 146 b oflock out 146 in contact with the outer periphery of the inner rim ofcounter dial 192.

Turning now to FIGS. 14-19B, the operation of clip applier 100 isprovided. Prior to any initial squeezing of handles 106 of clip applier100 and with clip applier 100 fully loaded with clips “C,” as seen inFIGS. 14-14C, drive channel 140 is located at a proximal-most position,indicia 192 b of counter dial 192 of mechanical counter mechanism 190,relating to a fully loaded clip applier 100, in the present instancebeing fully loaded with twenty-two (22) clips, is visible through window104 c formed in housing half 104 b. Accordingly, as seen in FIG. 14B,the numeral “22” is visible through window 104 c. Also, as seen in FIG.14B, resilient finger 196 a of latch member 196 is engaged in a groove192 f formed around the outer periphery of counter dial 192.

As seen in FIG. 14C, prior to any squeezing of handles 106, clutch pin194 d of counter clutch 194 is disposed at a distal end of angled slot140 a of drive channel 140. Also, first catch 146 b of lock out 146 isin contact with the outer periphery of the inner rim of counter dial 192so that second catch 146 c of lock out 146 is disengaged from rackmember 141. Moreover, prior to any squeezing of handles 106, and whenclip applier 100 is fully loaded with clips, groove 192 g formed in theouter periphery of the inner rim of counter dial 192 is oriented distalof first catch 146 b of lock out 146.

As seen in FIGS. 15-15B, during an initial squeeze of handles 106, asindicated by arrow “A1,” drive pin 124 translates drive channel 140 andrack member 141 in a distal direction, as indicated by arrow “B1.” Asdrive channel 140 is translated in a distal direction, angled slot 140 aof drive channel 140 is moved in a distal direction relative to clutchpin 194 d of counter clutch 194, clutch pin 194 d is cammed throughangled slot 140 a of drive channel 140 causing counter clutch 194 torotate in the direction of arrow “C1.” As counter clutch 194 is rotatedin the direction of arrow “C1,” as seen in FIG. 15B, resilient fingers194 b, 194 c thereof engage uni-directional teeth 192 e of dial 192,thereby causing dial 192 to also rotate in the direction of arrow “C1.”Moreover, as dial 192 is rotated in the direction of arrow “C1,” groove192 g formed in the outer periphery of the inner rim of counter dial 192is rotated away from first catch 146 b of lock out 146 as first catch146 b continues to ride along the outer periphery of the inner rim ofcounter dial 192.

As dial 192 is rotated in the direction of arrow “C1,” as seen in FIG.15A, indicia 192 b of numeral “22” is moved relative to window 104 cformed in housing half 104 b, thereby beginning to decrement.Additionally, as dial 192 is rotated in the direction of arrow “C1,”resilient finger 196 a of latch member 196 begins to disengage thegroove 192 f formed around the outer periphery of counter dial 192.

As seen in FIGS. 16-16B, during a final or complete squeeze of handles106, as indicated by arrow “A1,” drive pin 124 further translates drivechannel 140 and rack member 141 in a distal direction, as indicated byarrow “B1.” As drive channel 140 is further translated in a distaldirection, angled slot 140 a of drive channel 140 is further moved in adistal direction relative to clutch pin 194 d of counter clutch 194,clutch pin 194 d is further cammed through angled slot 140 a of drivechannel 140 causing counter clutch 194 to further rotate in thedirection of arrow “C1.” As counter clutch 194 is further rotated in thedirection of arrow “C1,” as seen in FIG. 16B, resilient fingers 194 b,194 c continue to cause dial 192 to rotate in the direction of arrow“C1.” Moreover, as dial 192 is further rotated in the direction of arrow“C1,” groove 192 g formed in the outer periphery of the inner rim ofcounter dial 192 is further rotated away from first catch 146 b of lockout 146 as first catch 146 b further continues to ride along the outerperiphery of the inner rim of counter dial 192.

As dial 192 is further rotated in the direction of arrow “C1,” as seenin FIG. 16A, indicia 192 b of numeral “22” is completely moved out ofview of window 104 c formed in housing half 104 b and new numeral “21”is moved into view of window 104 c, thereby fully being decremented.This change of numeral, or decrementing, coinciding with a formationand/or firing/ejection/release of a clip from clip applier 100. In thismanner, the user is shown the number of clips remaining in clip applier100 and available to fire. Additionally, as dial 192 is further rotatedin the direction of arrow “C1,” resilient finger 196 a of latch member196 moves into engagement in a groove 192 f′ adjacent to groove 192 fformed around the outer periphery of counter dial 192.

Turning now to FIGS. 17-18, during an opening of handles 106, asindicated by arrow “A2,” drive pin 124 translates drive channel 140 andrack member 141 in a proximal direction, as indicated by arrow “B2.” Asdrive channel 140 is translated in a proximal direction, angled slot 140a of drive channel 140 is moved in a proximal direction relative toclutch pin 194 d of counter clutch 194, clutch pin 194 d is cammedthrough angled slot 140 a of drive channel 140 causing counter clutch194 to rotate in the direction of arrow “C2,” opposite to “C1.” Ascounter clutch 194 is rotated in the direction of arrow “C2,” as seen inFIG. 17B, resilient fingers 194 b, 194 c are caused to deflect and snapover uni-directional teeth 192 e of dial 192. as seen from FIG. 17A, anyfrictional forces tending to cause dial 192 to also rotate in thedirection of arrow “C2” and negated by the engagement of resilientfinger 196 a of latch member 196 in groove 192 f′ formed around theouter periphery of counter dial 192, thereby maintaining the rotationalorientation of dial 192.

With dial 192 being held or maintained in this rotational orientation,indicia 192 b of numeral “21” is maintained in view in window 104 c.

As seen in FIG. 18, when drive channel 140 has been moved back to thefully proximal position, resilient fingers 194 b, 194 c of counterclutch 194 are re-set in engagement with adjacent uni-directional teeth192 e of dial 192.

Additionally, as dial 192 is further rotated in the direction of arrow“C1,” resilient finger 196 a of latch member 196 moves into engagementin a groove 192 f adjacent to groove 192 f formed around the outerperiphery of counter dial 192.

Turning now to FIGS. 19-19B, during the squeezing of handles 106, uponthe firing of a final clip loaded in clip applier 100, indicia 192 b ofdial in the form of numeral “0” is completely moved into view of window104 c formed in housing half 104 b, thereby indicating to the user thatno more clip are present in clip applier 100. When dial 192 has beenrotated to this position, as seen in FIGS. 19A and 19B, groove 192 gformed in the outer periphery of the inner rim of counter dial 192 isrotated into registration with first catch 146 b of lock out 146. Inthis position, biasing member 147, acting on lock out 146, urges firstcatch 146 b of lock out 146 into groove 192 g of dial 192.

Additionally, in the present position, second catch 146 c of lock out146 is moved into notch 141 c formed in side edge of rack member 141 andthus into the path of proximal translation of rack member 141.Accordingly, as handles 106 are released and drive pin 124 begins tomove rack member 141 in a proximal direction, notch 141 c of rack member141 engages second catch 146 c of lock out 146 thereby prohibiting rackmember 141 from returning to a proximal most or home position. With rackmember 141 being inhibited or blocked from returning to the proximalmost position, ratchet pawl 142 of ratchet mechanism 144 (see FIG. 5) isprevented from resetting itself. Since pawl 142 is prevented fromresetting itself, handles 106 can not be re-actuated or re-squeezedsince they have only been partially opened. Once again, reference may bemade to U.S. Provisional Application No. 61/091,467, filed on Aug. 25,2008, entitled “Surgical Clip Applier;” U.S. Provisional Application No.61/091,485, filed on Aug. 25, 2008, entitled “Surgical Clip Applier andMethod of Assembly;” and U.S. Provisional Application No. 61/286,569,filed on Dec. 15, 2009, entitled “Surgical Clip Applier”, for a detaileddiscussion of the structure, operation, and method of assembly ofvarious components of surgical clip applier 100.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

1-16. (canceled)
 17. A surgical clip applier, comprising: a housing; adrive channel translatably supported in the housing; and a countermechanism supported in the housing and including: a counter dialrotatably supported in the housing, the counter dial including a firstface and an opposing second face, the first face defining indiciavisible through the housing and the second face defining a bore therein,the bore including a perimetrical array of uni-directional teeth; and acounter clutch engagably nested in the bore defined in second face ofthe counter dial and operatively coupled to the drive channel, thecounter clutch including at least one resilient finger extendingtangentially therefrom and configured to rotatably engage theuni-directional teeth of the bore to rotate the counter dial in a singledirection relative to the drive channel.
 18. The surgical clip applieraccording to claim 17, wherein when the drive channel is translated in afirst direction relative to the housing, the counter clutch isconfigured to rotate in a first direction relative to the drive channelsuch that the at least one resilient finger of the counter clutchengages the uni-directional teeth of the bore to rotate the counter dialin the first direction relative to the drive channel, and wherein whenthe drive channel is translated in a second direction relative to thehousing, the counter clutch is configured to rotate in a seconddirection relative to the drive channel such that the at least oneresilient finger of the counter clutch disengages from theuni-directional teeth of the bore and the counter dial is not rotated inthe second direction relative to the drive channel.
 19. The surgicalclip applier according to claim 18, wherein the counter mechanismincludes a latch member configured to contact and selectively engage thecounter dial, wherein the latch member permits rotation of the counterdial in the first direction relative to the drive channel and inhibitsrotation of the counter mechanism in the second direction relative tothe drive channel.
 20. The surgical clip applier according to claim 19,wherein the counter dial includes a first rim defining a plurality ofgrooves formed around an outer periphery thereof and a second rimdefining a lockout groove formed in an outer periphery thereof, whereinthe latch member is configured to contact and selectively engage theplurality of grooves formed on the outer periphery of the first rim. 21.The surgical clip applier according to claim 20, wherein the countermechanism includes a ratchet mechanism having: a rack membertranslatably supported in the housing and operatively coupled to thedrive channel, the rack member including a first edge and an opposingsecond edge, the first edge defining a plurality of ratchet teeth andthe second edge defining a notch; and a ratchet pawl supported in thehousing, the ratchet pawl resiliently biased to engage the plurality ofratchet teeth defined on the first edge of the rack member to restricttranslation of the rack member relative to the housing.
 22. The surgicalclip applier according to claim 21, further including: a clip carrier; aplurality of clips loaded in the clip carrier; a lock out membersupported in the housing, the lock out member having a body portiondefining a first catch and a second catch, the first catch configured toengage the lock out groove formed in the second rim of the counter dialand the second catch configured to engage the notch defined on thesecond edge of the rack member; and a lock out spring resiliently biasedto maintain the first catch of the lock out member in contact with theouter periphery of the second rim of the counter dial, wherein as thecounter dial is rotated in the first direction relative to the drivechannel, the first catch of the lock out member is brought intoregistration with the lock out groove when a final clip of the pluralityof clips has been fired to inhibit further rotation of the counter dialin the first direction relative to the drive channel.
 23. The surgicalclip applier according to claim 22, wherein when the final clip of theplurality of clips has been fired and the first catch of the lock outmember is brought into registration with the lock out groove, the secondcatch of the lock out member is brought into registration with the notchdefined on the second edge of the rack member such that the rack memberis prevented from translating relative to the housing.
 24. The surgicalclip applier according to claim 23, further including at least onehandle pivotably connected to the housing, the at least one handleconfigured to actuatably translate the drive channel, wherein when thesecond catch of the lock out member is brought into registration withthe notch defined on the second edge of the rack member, the at leastone handle is prevented from actuation.
 25. The surgical clip applieraccording to claim 24, wherein the lock out groove of the counter dialis associated with the indicia on the first face of the counter dialindicating that the final clip of the plurality of clips has been fired.26. The surgical clip applier according to claim 25, wherein the indiciaon the first face of the counter dial indicating that the final clip ofthe plurality of clips has been fired is represented by a number “zero.”27. A surgical clip applier, comprising: a housing; a clip carrier; aplurality of clips loaded in the clip carrier; a drive channeltranslatably supported in the housing; a counter mechanism supported inthe housing and including: a counter dial rotatably supported in thehousing, the counter dial including a recess having a circular array ofuni-directional teeth; and a counter clutch rotatably nested in therecess defined in the counter dial and operatively coupled to the drivechannel, the counter clutch configured to rotatably engage theuni-directional teeth of the recess to rotate the counter dial in asingle first direction relative to the drive channel; and a lock outmember supported in the housing and resiliently biased to maintaincontact with the counter dial as the counter dial rotates in the firstdirection relative to the drive channel, wherein when a final clip ofthe plurality of clips is fired, the lock out member is configured toengage the counter dial to inhibit further rotation of the counter dialin the first direction relative to the drive channel.
 28. The surgicalclip applier according to claim 27, wherein the counter clutch includesat least one resilient finger extending tangentially therefrom andconfigured to rotatably engage the uni-directional teeth of the recessof the counter dial in the first direction relative to the drivechannel.
 29. The surgical clip applier according to claim 28, whereinwhen the drive channel is translated in a first direction relative tothe housing, the counter clutch is configured to rotate in the firstdirection relative to the drive channel such that the counter dial isrotated in the first direction relative to the drive channel.
 30. Thesurgical clip applier according to claim 29, wherein when the drivechannel is translated in a second direction relative to the housing, thecounter clutch is configured to rotate in a second direction relative tothe drive channel such that the at least one resilient finger of thecounter clutch disengages from the uni-directional teeth of the recessof the counter dial and the counter dial is not rotated in the seconddirection relative to the drive channel.
 31. The surgical clip applieraccording to claim 29, wherein the counter dial includes a first faceand an opposing second opposing face, the first face defining indiciavisible through the housing and the second face defining the recesstherein.
 32. The surgical clip applier according to claim 31, whereinthe counter dial includes a lockout groove formed in an outer peripherythereof, wherein when the lock out member is brought into registrationwith the lock out groove, the counter dial is prevented from rotating inthe first direction relative to the drive channel.